Provider Demographics
NPI:1013039122
Name:BRUMAND, SASSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:SASSON
Middle Name:
Last Name:BRUMAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 721182
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92172-1182
Mailing Address - Country:US
Mailing Address - Phone:619-640-3400
Mailing Address - Fax:619-283-2584
Practice Address - Street 1:4242 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 24
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2611
Practice Address - Country:US
Practice Address - Phone:619-640-3400
Practice Address - Fax:619-283-2584
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist